METHODS

Medical records at The Hospital for Sick Children (Toronto, Ontario) were reviewed
on a single day in September 2007. Pain assessment and management practices, and pain
prevalence and intensity in the preceding 24 h were recorded on a standardized data
collection form. Where possible, pain outcomes were compared with previous audit results.

RESULTS

Records of 265 inpatients were audited. Sixty-three per cent of children underwent
a documented pain assessment compared with 27% in an audit conducted previously (P<0.01).
Eighty-three per cent of children with documented pain received at least one pain
management intervention. Overall, 51% of children received pharmacological therapy,
and 15% received either a psychological or physical pain-relieving intervention. Of
those assessed, 44% experienced pain in the previous 24 h versus 66% in the previous
audit (P<0.01). Fewer children experienced severe pain compared with the first audit
(8.7% versus 26.1%; P<0.01). One-third of children received opioids; 19% of these
had no recorded pain assessment. Among 131 children who underwent a painful procedure,
21% had a concurrent pain assessment. Painful procedures were accompanied by a pain-relieving
intervention in 12.5% of cases.